AIMS/OBJECTIVES:Cytomorphometry analysis in exfoliative cytology for the early identification of dysplasia in Oral Potentially Malignant Disorders (OPMDs) has gained interest. However, there are no standardized quantitative cytomorphometric reference values for dysplasia. Meta-analysis of cytomorphometry parameters to support a recommendation of quantitative values for discriminating between OPMDs as non-dysplastic or dysplastic lesions was carried out. METHODS:Using the PubMed, Scopus, and Web of Science, a search for relevant studies was undertaken using search phrases and keywords for identification. The mean values and standard deviations of cytomorphometric parameters for normal mucosa, OPMDs, and OSCC were extracted. A random-effects meta-analysis was performed and pooled values were obtained to establish a quantitative recommendation. RESULTS:Eight studies were included. Pooled estimates showed a decrease in cellular area (SMD: -1.50) and cellular diameter (SMD: -2.43), whereas an increase was observed in nuclear area (SMD: 2.35), nuclear diameter (SMD: 1.10), nuclear-cellular area ratio (SMD: 3.26), and nuclear-cellular diameter (SMD:1.74) in OPMDs with dysplasia compared to normal mucosa. A cellular area of less than 6058.33 square microns and a nuclear area greater than 139.40 square microns could indicate dysplastic changes. Similarly, a nuclear-cellular area ratio exceeding 0.058 may help differentiate normal mucosa from dysplastic OPMD. CONCLUSION:We recommend quantitative cytomorphometric values (CA < 6058.33 μm², NA > 139.40 μm², and NA:CA ratio > 0.058) as reference standards for identification of dysplastic changes in OPMDs. Cytopathologists and pathologists should use these recommended values when faced with a diagnostic dilemma regarding dysplasia in OPMDs.

The objective was to estimate the pooled prevalence of suicidal ideation (SI) and related risk factors in oral cancer (OC). Studies that specified SI in OC patients were considered eligible. SI prevalence and associated risk factors were extracted from the included studies for qualitative analysis and meta-analysis. Five studies (two retrospective, two cross-sectional, and one prospective longitudinal) were included in this review. Out of a total 15,475 OC patients, SI was reported in 117. The pooled prevalence of SI was 6% (95% confidence interval 1–22%). The prevalence of SI varied widely across the included studies, from 0.26% to 18.7%. Four studies described SI assessment methods, which were DS-MV, PHQ-9, Beck Scale for Suicidal Ideation, and psychiatric interviews. Older age, depression, demoralization, previous cancer history, psychiatric history, alcohol dependence, anxiety, living alone, and poor quality of life were frequently mentioned as risk factors of SI. The prevalence of SI varied across studies and was probably affected by the method of assessment, treatment, and postoperative care. SI was consistently predicted with psychological distress. It is essential to raise awareness of demographic, clinical, and psychological associations with SI in order to assess risks and design interventions for this cohort.

OBJECTIVES:An umbrella review is a systematic review of systematic reviews, which provides a tertiary level of evidence. This umbrella review of systematic reviews and meta-analysis (SR-MA) aimed to determine the proportion of oral cancer (OC) development in oral submucous fibrosis (OSF) patients. MATERIALS AND METHODS:We searched electronic databases including PubMed, Scopus, Web of Science, Cochrane and grey literature. Two reviewers independently screened abstracts and assessed for eligible papers. The methodological quality of SR-MA was evaluated using AMSTAR2, and we also checked the quality of evidence of the included papers. RESULTS:Out of 454 papers identified in the primary search, 105 underwent eligibility screening. Inclusion criteria were met by four SR-MA. OC ratios ranged between 4.2% and 6% for OSF. Substantial heterogeneity was observed for this outcome in all four MA (I2 = 71.31% to 86.37%). None of the SRs assessed the quality of evidence, and half of them were judged to be of critically low methodological quality. CONCLUSION:There is lack of quality of evidences and critically low methodological quality among SRs and MA leading to substantial heterogeneity. However, due to potentially malignant nature, OSF patients should be monitored carefully for early detection of OC.

OBJECTIVE:This systematic review was performed to evaluate the range of outcome measures used in interventional trials for oral submucous fibrosis (OSF). MATERIALS AND METHODS:PubMed, Scopus, and Cochrane databases were searched to identify randomized controlled trials (RCTs) published from 2004 to 2018 about OSF treatment. All the outcome measures and measurement methods mentioned in the trials were extracted and analyzed. RESULTS:Out of 120 published papers, 12 RCTs that met the inclusion criteria were included. A total of 38 single outcome measures and 29 composite outcome measures were considered under four different outcome domains, of which clinical symptoms and clinical response were the most commonly used. The linear measurement of mouth opening (11 trials; 91.66%) and Visual Analogue Scale (10 trials, 83.33%) were the predominant measurement methods. CONCLUSIONS:This systematic review highlights the high heterogeneity in outcome measures in therapeutic RCTs of OSF. This lack of widely agreed standard outcome measures in OSF is a great concern as it prevents the comparison of studies and meta-analyses to gather evidence. There is a dire need of establishing a core outcome set for reporting in the future clinical trials that may help facilitate treatment choice for OSF to improve life quality of patients.

Background:Metastasizing Ameloblastoma (MA) is an aggressive variant of ameloblastoma (AM) with the ability to metastasize without cytological malignant changes. Thus it aims to comprehensively review the clinico-pathological and prognostic aspects of MA through integration of current literature.Methods:Electronic searches were conducted in PubMed-MEDLINE, Scopus, Web of Science and Google Scholar. Two independent reviewers screened abstracts and evaluated paper eligibility. AMSTAR2 checklist was used to assessed methodological quality of included systematic reviews (SRs).Results:From 390 initial papers, 279 underwent eligibility screening, with five systematic reviews (SRs) meeting inclusion criteria. Six hundred sixty-one MA cases were found in five SRs that were included. MA predominantly affects men, exhibits mandible preference, and occurs in individuals in their fourth or fifth decade. Benign metastatic deposits commonly manifest in lungs and lymph nodes. Distant metastasis probability rises with multiple recurrences and incomplete surgical removal. Tumor recurrence and metastasis unfavorably impact clinical outcomes. Quality of evidence assessment was absent across SRs; four SRs were critically low in methodological quality.Conclusions:AM's metastatic potential lacks predictability. Early/multiple recurrences post-treatment may signal poor prognosis, warranting vigilant follow-up. Methodical analysis of each AM case is imperative to comprehend the metastatic-benign histology relationship.

Objective: According to findings from the previous studies, quitting smoking can significantly reduce mortality from all causes and is linked to better treatment results. Even though quitting smoking has many benefits, little is known about the evidence supporting the particular quit services offered to smokers after a cancer diagnosis. Methods: To find the articles related to area in question, different electronic databases including PubMed/Medline, Google Scholar, and EBSCO were searched on April 1st, 2023. All full text randomized controlled trials with one or more intervention and control groups that assessed the outcomes of smoking cessation interventions were included. Participants of included studies were adults diagnosed with head and neck cancer (HNC) and current smokers or those who had recently quit. There were interventions (pharmacological and/or pharmacological) that aimed to help patients with HNC succeed in quitting smoking. Results: We identified 15352 papers from the initial search from different electronic databases, 2560 remained after excluding duplicates. After screening titles and abstracts for relevance, 2345 articles were removed. Full text articles of remaining 215 papers were assessed in depth by two reviewers for their eligibility, amongst which, 210 articles were excluded. Finally, we included five papers that met the inclusion criteria in the present systematic review. Conclusion: According to the findings of this review, a multi - component strategy might very well benefit patients with HNC who smoke cigarettes after diagnosis. More studies with high methodological quality and standardized outcome measures must be conducted in this population to inform the development of smoking cessation program.

Understanding the carcinogenesis mechanism of different carcinogenic agents is paramount for implementing preventive and therapeutic strategies for cancer. Hence, an appropriate simulation of the clinical situation in preclinical studies should be the prime mandate for reaching the validated and pragmatic conclusion. In Asian and Southeast Asian countries, one of the most common etiological agents for oral squamous cell carcinoma (OSCC) is the consumption of betel quid (BQ) with and without tobacco. BQ is marketed in the form of a mixture of various ingredients. It is quite conceivable that when BQ is placed or chewed in the oral cavity, all the carcinogenic components released from different agents get mixed and forms an amalgamation of carcinogens. To further add to the complexity, oral microbial flora also becomes part and parcel of this amalgamation. We envisage the interactions of various carcinogens with each other and the salivary components and microbial flora. However, this clinical scenario is not exactly simulated in various in-vitro experimental studies published in the literature. To better understand the oral carcinogenesis mechanism, it becomes imperative to consider the aforementioned fact in mind while studying carcinogens for oral cancer. In the present commentary, we have made an effort to discuss the amalgamation of the carcinogens in the oral cavity and propose the possible preclinical model to study carcinogens associated with OSCC.

• Clinicians over the years are trying to treat OSCC using various modalities with no visible outcome. • Several drugs were experimented in OSCC; however, these were primarily used in treatment of tumours of other parts of body. • Limited number of clinical drug trials in OSCC reflect poorly on development of an effective anti-cancer drug for OSCC. • Several OSCC specific factors must be considered in development of drug of OSCC. It included the oral environment, microbiome, oral mucosal phenotype, biology, and their interaction with each other. • To increase success and development of effective anti-cancer drug, a CT with worldwide collaboration for better representation of the population groups must be carried out.

• Prediction of MT in OPMDs is a greatest challenge for the investigators. • Any consistent feature at surgical margins can be a vital prognostic marker for MT. • Inflammation similar to lichenoid infiltrates is linked to a poor prognosis in OSCC. • Lichenoid infiltrate OSF could be an indictor for initiation of MT in OSF.

Future OncologyVol. 18, No. 35 EditorialPerspective on the risk of suicide associated with oral cancer diagnosisGargi S Sarode, Namrata Sengupta, Monal Yuwanati, Shailesh Gondivkar, Amol Gadbail, Prashit Upadhyay & Sachin C SarodeGargi S Sarode https://orcid.org/0000-0003-4628-8866Department of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India, Namrata Sengupta https://orcid.org/0000-0002-5998-066XDepartment of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India, Monal Yuwanati https://orcid.org/0000-0001-9233-8292Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, 600077, India, Shailesh Gondivkar https://orcid.org/0000-0003-0704-7509Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India, Amol Gadbail https://orcid.org/0000-0002-6546-7694Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, India, Prashit UpadhyayDepartment of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India & Sachin C Sarode *Author for correspondence: Tel.: +91 992 249 1465; E-mail Address: drsachinsarode@gmail.comhttps://orcid.org/0000-0003-1856-0957Department of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, IndiaPublished Online:8 Nov 2022https://doi.org/10.2217/fon-2022-0991AboutSectionsView ArticleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinkedInRedditEmail View articleKeywords: head and neck cancermortalityoral cancerpsychological stresssuicidePapers of special note have been highlighted as: • of interestReferences1. McFarland DC, Walsh L, Napolitano S, Morita J, Jaiswal R. Suicide in patients with cancer: identifying the risk factors. Oncology (NY, USA) 33(6), 221–226 (2019).Medline, Google Scholar2. Choi Y, Park EC. Suicide after cancer diagnosis in South Korea: a population-based cohort study. BMJ Open. 11(9), e049358 (2021). Crossref, Medline, Google Scholar3. Robson A, Scrutton F, Wilkinson L, MacLeod F. The risk of suicide in cancer patients: a review of the literature. Psychooncology 19(12), 1250–1258 (2010). Crossref, Medline, Google Scholar4. Sun LM, Lin CL, Shen WC, Kao CH. Suicide attempts in patients with head and neck cancer in Taiwan. Psychooncology 29(6), 1026–1035 (2020). Crossref, Medline, Google Scholar5. Osazuwa-Peters N, Simpson MC, Zhao L et al. Suicide risk among cancer survivors: head and neck versus other cancers. Cancer 124(20), 4072–4079 (2018). • The only published literature where suicide risk was discussed in the context of head and neck cancerCrossref, Medline, Google Scholar6. Chang TG, Huang PC, Hsu CY, Yen TT. Demoralization in oral cancer inpatients and its association with spiritual needs, quality of life, and suicidal ideation: a cross-sectional study. Health Qual. Life Outcomes 20(1), 60 (2022). • Discusses the risk of suicide associated particularly with oral cancerCrossref, Medline, Google Scholar7. Kligerman MP, Divi V. Physician-assisted suicide for patients with head and neck cancer. Otolaryngol. Head Neck Surg. 163(4), 759–762 (2020). • Reports physician-assisted suicide especially in oral cancer populationCrossref, Medline, Google Scholar8. Suzuki M, Deno M, Myers M et al. Anxiety and depression in patients after surgery for head and neck cancer in Japan. Palliat. Support Care 14(3), 269–277 (2016). Crossref, Medline, Google Scholar9. Rhoten BA, Murphy B, Ridner SH. Body image in patients with head and neck cancer: a review of the literature. Oral Oncol. 49(8), 753–760 (2013). Crossref, Medline, Google Scholar10. Verrocchio MC, Carrozzino D, Marchetti D, Andreasson K, Fulcheri M, Bech P. Mental pain and suicide: a systematic review of the literature. Front. Psychiatry 7, 108 (2016). Crossref, Medline, Google Scholar11. Giddens JM, Sheehan KH, Sheehan DV. The Columbia–Suicide Severity Rating Scale (C-SSRS): has the "gold standard" become a liability? Innov. Clin. Neurosci. 11(9-10), 66–80 (2014).Medline, Google Scholar12. Sharp R. The Hamilton Rating Scale for depression. Occup. Med. (Lond.) 65(4), 340 (2015). Crossref, Medline, Google Scholar13. Mamdani F, Weber MD, Bunney B et al. Identification of potential blood biomarkers associated with suicide in major depressive disorder. Transl. Psychiatry 12, 159 (2022). Crossref, Medline, CAS, Google Scholar14. Ren ZH, Hu CY, He HR, Li YJ, Lyu J. Global and regional burdens of oral cancer from 1990 to 2017: results from the Global Burden of Disease study. Cancer Commun. (Lond.) 40(2-3), 81–92 (2020). Crossref, Google ScholarFiguresReferencesRelatedDetails Vol. 18, No. 35 STAY CONNECTED Metrics Downloaded 35 times History Received 6 October 2022 Accepted 20 October 2022 Published online 8 November 2022 Published in print November 2022 Information© 2022 Future Medicine LtdKeywordshead and neck cancermortalityoral cancerpsychological stresssuicideFinancial & competing interests disclosureThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.No writing assistance was utilized in the production of this manuscript.PDF download

Background:The objective of this study was to estimate serum vitamin B12 levels and its correlation with severity of clinical presentation in patients with trigeminal neuralgia (TN).Methods:A total of 80 participants were included and rendered into study group: 40 TN patients and control group: 40 healthy individuals. The serum vitamin B12 estimation of each participant was carried out by using serum vitamin B12 ELISA kit and pain characteristics of TN patients were recorded in details.Results:The mean serum vitamin B12 level was noticed to be significantly lower (p = 0.042) in study group (296.87 ± 248.75 pg/mol) as compared to control group (423.5 ± 296.41 pg/mol). There was a statistically significant difference in serum vitamin B12 level between vegetarian TN patients and those who were on mixed diet (p = 0.001). The pain associated with TN predominantly reported unilaterally involving the right side (55%), female gender (55%) and mandibular division (50%). Although pain intensity showed no significant relation (p = 0.024), duration of pain reported a strong negative association with mean serum vitamin B12 levels in TN patients (p = 0.001).Conclusions:Vitamin B12 supplements can be added to the established treatment protocol for the holistic management of TN patients particularly those who are on vegetarian diet.

Background: Association with variety of etiological agents is one of the characteristic features of oral squamous cell carcinoma (OSCC). We hypothesized the existence of tobacco consumption habit-based heterogeneity in the immunohistochemical expression of carcinogenesis relevant molecular markers in OSCC. Hence, the present study was conducted to investigate the carcinogenesis relevant three commonly expressed markers (Ki-67, CD105, and α-smooth muscle acting [SMA]) in various forms of tobacco consumption habits in OSCC patients. Materials and Methods: A total of 217 patients of OSCC were included in the study, and based on the habit, they were broadly categorized into tobacco lime (TL), TL and areca nut (TLAN), and areca nut (AN). Further, categorization was done on the basis of absence or presence of additional habit of smoking. Immunohistochemistry (IHC) was performed using Ki-67, CD105, and α-SMA markers on formalin-fixed paraffin-embedded tissues. Results: TLAN (62.21%) was the most common habit noted in OSCC patient followed by TL (20.73%) and AN (15.20%). The additional habit of smoking was observed in 31.11% and 25.92% of TL and TLAN habits of OSCC patients, respectively. All the three markers (Ki-67, CD105, and α-SMA) showed statistically significant differences in the habit group such as TL, TLAN, and AN (P < 0.001). Although the expression of all the three markers was increased in TL as compared with TLAN, differences were not statistically significant. When these markers were compared in with and without smoking category, only TLAN with smoking and TLAN without smoking showed statistically significant differences in the expression of all three markers. Conclusions: Ki-67 CD105 and α-SMA immunohistochemical expression in OSCC corresponds with different forms of tobacco consumption habits. Habit-related unique carcinogenesis events are reflected at IHC level thus providing proof of concept for future studies.

Future OncologyVol. 18, No. 15 EditorialModern lifestyle, stress and metabolism: possible risk factors for oral carcinogenesis in the young generationMonal Yuwanati, Sachin C Sarode, Amol Gadbail, Shailesh Gondivkar & Gargi SarodeMonal Yuwanati *Author for correspondence: Tel.: +91 903 901 1909; E-mail Address: monal9817@gmail.comhttps://orcid.org/0000-0001-9233-8292Department of Oral & Maxillofacial Pathology & Microbiology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, 600077, India, Sachin C Sarode https://orcid.org/0000-0003-1856-0957Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra, Pune, 411018, India, Amol Gadbail https://orcid.org/0000-0002-6546-7694Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, 440009, India, Shailesh Gondivkar https://orcid.org/0000-0003-0704-7509Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, 440009, India & Gargi Sarode https://orcid.org/0000-0003-4628-8866Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Maharashtra, Pune, 411018, IndiaPublished Online:21 Mar 2022https://doi.org/10.2217/fon-2022-0053AboutSectionsView ArticleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinkedInReddit View articleKeywords: carcinogenesisglucocorticoidsGLUTmetabolismmodern lifestyleoral cancerstressReferences1. Suraiya JN. Medicine in ancient India with special reference to cancer. 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S Gondivkar and A Gadbail helped collect and analyze the data.Financial & competing interests disclosureThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.No writing assistance was utilized in the production of this manuscript.PDF download

Future OncologyVol. 17, No. 17 EditorialOral submucous fibrosis and heterogeneity in outcome measures: a critical viewpointSachin C Sarode, Shailesh Gondivkar, Amol Gadbail, Gargi S Sarode & Monal YuwanatiSachin C Sarode *Author for correspondence: Tel.: +91 992 249 1465; E-mail Address: drsachinsarode@gmail.comhttps://orcid.org/0000-0003-1856-0957Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, 411018, Maharashtra, India, Shailesh GondivkarDepartment of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, 440003, Maharashtra, India, Amol GadbailDepartment of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, 440018, Maharashtra, India, Gargi S Sarode https://orcid.org/0000-0003-4628-8866Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, 411018, Maharashtra, India & Monal Yuwanati https://orcid.org/0000-0001-9233-8292Department of Oral Pathology & Microbiology, Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, 600077, IndiaPublished Online:16 Apr 2021https://doi.org/10.2217/fon-2021-0287AboutSectionsView ArticleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinkedInReddit View articleKeywords: measurement methodsoral submucous fibrosisoutcome measuresPapers of special note have been highlighted as: • of interest; •• of considerable interestReferences1. Warnakulasuriya S, Kujan O, Aguirre-Urizar JM et al. Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. 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This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.No writing assistance was utilized in the production of this manuscript.PDF download

Oral submucous fibrosis (OSMF) causes desmoplasia and rigidity of submucosa of the oral cavity, resulting in reduced mouth opening, and in advanced stage causes difficulty in swallowing. OSMF has poor morbidity in terms of oral function as well as general health due to loss of oral function, such as eating. In severe conditions, it can cause dysphagia and hearing loss. Various clinicians have tried the different treatment modalities to reverse the disease process, but with limited success and that too in alleviating the associated symptoms.